经皮肾镜与腹腔镜治疗输尿管上段结石的临床疗效比较  

The comparison of efficacy of Percutaneous nephrolithotomy and laparoscopic treatment for ureteral calculi

作　　者：唐智旺 汪志民 吴铁球 李南南 

机构地区：[1]长沙市第一医院泌尿外科,湖南410005

出　　处：《国际泌尿系统杂志》2014年第4期499-502,共4页International Journal of Urology and Nephrology

基　　金：国家自然科学基金资助项目（No.81101634）

摘　　要：目的 探讨经皮肾镜与腹腔镜治疗输尿管上段结石的临床疗效.方法 回顾和分析本院自2011年1月～2013年3月收治的输尿管上段结石患者共74例,其中经皮肾镜组39例、腹腔镜组35例,对比研究两组患者各项临床疗效指标.结果 经皮肾镜组一次性清石率为92.31％,术后并发症发生率为12.82％,腹腔镜组一次性清石率为94.29％,术后并发症发生率为11.43％,两组患者一次性清石率、术后并发症发生率无统计学差异（P＞0.05）.腹腔镜组手术时间较经皮肾镜组长,而术后卧床时间、平均住院时间、术中出血量少于经皮肾镜组,差异有统计学意义（P＜0.05）.结论 经皮肾镜与腹腔镜技术治疗输尿管上段结石安全、有效.对多发性输尿管上段结石,经皮肾镜技术效果确切;腹腔镜不受输尿管通畅性影响,术中出血量少,对肾积水较轻、嵌顿时间长、单一较大输尿管上段结石可作为优先选择.临床可根据具体情况选择合适的手术方法提高患者手术清石率、降低手术并发症.Objectives To investigate the clinical results of percutaneous nephrolithotomy and laparoscopic treatment of ureteral calculi.Methods 74 cases of ureteral calculi were divided into percutaneous nephrolithotomy treatment group（n =39） and laparoscopic treatment group（n =35） from Jan 2011 to Mar 2013.The relevant factors of clinical outcomes were alaysized.Results The rate of Percutaneous nephrolithotomy group 1 （92.31％ vs 94.29％） and postoperative complication（12.82％ vs 11.43％） of percutaneous nephrolithotomy were not statistically significant （P ＞ 0.05） than laparoscopic treatment group.The percutaneous nephrolithotomy time of laparoscopic treatment group was longer than percutaneous nephrolithotomy treatment group.The bed time,the average length of hospital stay,less blood of laparoscopic treatment group were loss than percutaneous nephrolithotomy treatment group （P ＜ 0.05）.Conclusions Percutaneous nephrolithotomy and laparoscopic treatment of ureteral calculi are safe and effective surgical method,For multiple ureteral calculi,percutaneous nephroscope technical effect exactly ; Laparoscopy is not affected by ureteral smooth sex,intraoperative blood loss,less on kidney seeper is lighter,a single large ureteral calculi can be used as a preferred choice.Clinical according to the specific situation to choose the appropriate.

关 键 词：输尿管结石 肾造口术 经皮 腹腔镜检查 

分 类 号：R699.4[医药卫生—泌尿科学]